Patient and Clinician Characteristics Associated With Secure Message Content: Retrospective Cohort Study.

Area of Science:

• Digital Health Communication
• Health Disparities Research
• Patient-Provider Interaction

Background:

• Effective communication impacts patient outcomes, but varies by patient and clinician factors.
• Previous research has not examined how patient and clinician characteristics influence secure message content.

Purpose of the Study:

• To investigate patient and staff characteristics associated with the content of secure messages exchanged.
• To identify patterns in communication content based on demographics and health conditions.

Main Methods:

• Coded 18,309 secure messages from 1031 patients with hypertension/diabetes and 711 staff members.
• Conducted logistic regression analyses to assess associations between characteristics and message content.
• Examined message content sent by patients, sent to patients, and received by patients based on sender/receiver attributes.

Main Results:

• Younger patients were less likely to share clinical updates or request refills.
• Women were more likely to seek medical guidance but less likely to self-report biometrics.
• Black patients were more likely to request preventive care but less likely to request prescription changes or diagnostic procedures.
• Staff shared less guidance with younger and uninsured patients.
• Nurse practitioners shared more guidance and received more refill requests than physicians.

Conclusions:

• Differences in secure message content based on patient characteristics may exacerbate health disparities.
• Inequities in digital communication content can worsen disparities in satisfaction, trust, self-care, and health outcomes.
• Healthcare systems must evaluate secure messaging use to prevent perpetuating care disparities.